Effective October 1, 2011 the Anthem Elements policy deductible and coinsurance will change from the current $1,250 deductible and the $2,500 maximum out-of-pocket to the conditions stipulated below:


The Anthem policy (in network) will have a $2,000 individual deductible ($4,000 per family) and 30% coinsurance up to a maximum out-of-pocket of $5,000 per individual ($10,000 per family). 

 

The deductible is included in the out-of-pocket maximum. 

 

The Anthem policy is a major medical policy which covers medical services such as inpatient admissions, in and out patient surgeries, emergency care, chemotherapy, radiation therapy, and many other services. 

The Anthem policy is the 'Basic' side of the Basic Plus plan and is the only side affected by the above changes.

The Redwood Health Services product is an employer sponsored plan which covers services not offered by Anthem. Office visits, lab & x-ray, brand name drugs are examples. It comprises the 'Plus' side of the Basic Plus plan.

 

These services are designed by the employer under a Health Reimbursement Arrangement (HRA, Code Section 105). The employer establishes the medical services available to the employees as well as the copay and maximum benefit. The California Foundation of Medical Care (CFMC) network is used to access services and discounts (www.cfmcnet.org) for the 'Plus' side of the Basic Plus plan.

 

The benefit changes above will apply to new Basic Plus plans with an effective date of 10-1-2011 and after.

Existing Basic Plus plans with an anniversary/renewal date of 10-1-2011 and after will be subject to these changes.